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Eff. Date: 02/07/2023
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ACCOLATE, ZAFIRLUKAST |
469 KB |
PDF File
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Eff. Date: 09/12/2022
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ADDERALL, AMPHETAMINE, AMPHETAMINE ER, AMPHETAMINE/DEXTROAMPHET SALTS, AZSTARYS, ADZENYS, ADZENYS-ODT, AMPHETAMINE/DEXTROAMPHET SALTS ER, ADHASIA XR, APTENSIO XR, CLONIDINE, CONCERTA ER, COTEMPLA, DAYTRANA, DESOXYN, DEXMETHYLPHENIDATE, DEXEDRINE, DEXMETHYLPHENIDATE, DYANAVEL, EVEKEO, FOCALIN XR, FOCALIN, GUANFACINE, INTUNIV, JORNAY, METHAMPHETAMINE, METHYLIN, METHYLPHENIDATE, METHYLPHENIDATE ER, METHYLPHENIDATE CD, MYDAYIS, PROCENTRA, QELBREE, QUILLICHEW, QUILLIVANT, RITALIN, STRATTERA, VYVANSE, ZENZEDI |
741 KB |
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Eff. Date: 12/01/2022
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CERDELGA, CEREZYME, ELELYSO, MIGLUSTAT, VPRIV, ZAVESCA |
410 KB |
PDF File
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Eff. Date: 07/05/2022
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ALISKIREN, TEKTURNA |
2 MB |
PDF File
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Eff. Date: 12/01/2022
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ORALAIR |
792 KB |
PDF File
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Eff. Date: 10/18/2022
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GOCOVRI ER, OSMOLEX ER |
610 KB |
PDF File
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Eff. Date: 07/05/2022
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AKYNZEO, APREPITANT, EMEND, GRANISETRON HCL, SANCUSO |
717 KB |
PDF File
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Eff. Date: 08/01/2022
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ABILIFY, ABILIFY DISCMELT, ABILIFY MAINTENA, ABILIFY MYCITE, AMITRIPTYLINE/PERPHENAZINE, ASENAPINE, ARIPIPRAZOLE, ARISTADA ER, CAPLYTA, CHLORPROMAZINE, CLOZAPINE, CLOZAPINE ODT, CLOZARIL, FANAPT, FAZACLO, FLUPHENAZINE, GEODON, HALOPERIDOL, INVEGA ER, INVEGA HAFYERA, INVEGA SUSTENNA, INVEGA TRINZA, LATUDA, LOXAPINE, LYBALVI, MOLINDONE HCL, OLANZAPINE, OLANZAPINE ODT, OLANZAPINE/FLUOXETINE, ORAP, PALIPERIDONE ER, PERPHENAZINE, PERSERIS ER, PIMOZIDE, QUETIAPINE , REXULTI, RISPERDAL , RISPERDAL CONSTA, RISPERDAL M-TAB, RISPERIDONE, SAPHRIS, SECUADO, SEROQUEL, SYMBYAX, THIORIDAZINE, THIOTHIXENE, TRIFLUOPERAZINE, VERSACLOZ, VRAYLAR, ZIPRASIDONE, ZYPREXA, ZYPREXA RELPREVV, ZYPREXA ZYDIS |
346 KB |
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Eff. Date: 10/22/2022
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EPIDIOLEX, FINTEPLA |
813 KB |
PDF File
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Eff. Date: 11/29/2022
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ALPRAZOLAM, XANAX, CHLORDIAZEPOXIDE, MEPROBAMATE, OXAZEPAM, DIAZEPAM, CLONAZEPAM, KLONOPIN, CLORAZEPATE, TRANXENE T, LORAZEPAM, TEMAZEPAM, TRIAZOLAM, ZOLPIDEM, ESTAZOLAM, RESTORIL, TEMAZEPAM, ESZOPICLONE, LUNESTA, SONATA, ZALEPLON, INTERMEZZO, ZOLPIDEM, AMBIEN, EDLUAR, BELSOMRA, BUTISOL SODIUM, FLURAZEPAM, HETLIOZ, ROZEREM, DAYVIGO |
3 MB |
PDF File
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Eff. Date: 07/05/2022
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ARIKAYCE |
628 KB |
PDF File
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Eff. Date: 07/19/2021
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BUNAVAIL, BUPRENORPHINE, BUPRENORPHINE-NALOXON, SUBOXONE, ZUBSOLV |
1 MB |
PDF File
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Eff. Date: 10/20/2022
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CARISOPRODOL-ASPIRIN, CARISOPRODOL COMPOUND, CARISOPRODOL CPD-CODEINE, CARISOPRODOL, SOMA |
260 KB |
PDF File
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Eff. Date 04/01/2022
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NURTEC, UBRELVY |
674 KB |
PDF File
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Eff. Date 11/08/2022
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AIMOVIG, AJOVY, EMGALITY, NURTEC, QULIPTA |
782 KB |
PDF File
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Eff. Date: 10/20/2022
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BYLVAY, LIVMARLI |
743 KB |
PDF File
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Eff. Date: 10/20/2022
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ARMODAFINIL, MODAFINIL, NUVIGIL, PROVIGIL, SUNOSI, WAKIX |
406 KB |
PDF File
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Eff. Date: 10/22/2012
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|
22 KB |
PDF File
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Eff. Date: 12/09/2016
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|
18 KB |
PDF File
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Eff. Date: 11/18/2022
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ALA-HIST, ALLFEN DM TAB, AP-HIST DM LIQ, APRODINE TAB, BENZONATATE, BROMFED DM CGH SYR, BROMPHENIR-PSEUDO-DM SYR, BROTAPP, CHEST CONG RELIEF, CHLD DELSYM, CHLD COLD & CGH DM ELIXI, CHLD MUCINEX, CHLD DAYCLEAR ALL CGH, CHLO TUSS LIQ, CGH DM, CGH SYR, DALLERGY, DECONEX DMX TAB, DECONEX IR TAB, DELSYM, DEXTROMETHORPHAN ER, DIMAPHEN, ED A-HIST, ED BRON GP LIQ, ED CHLORPED D PEDIATRIC DROPS, ENDACOF-DM LIQ, EX ACTION CGH SYR, GUAIFEN, GUAIFEN ER, GUAIFEN/PSE, HISTEX, IOPHEN, KIDKARE CGH & COLD LIQ, KID'S MUCINEX MINI-MELTS PACK, LODRANE D CAPSULE, LOHIST, LORTUSS, MAXIPHEN, M-END DMX LIQ, M-HIST DM LIQ, MUCINEX, MUCUS RELIEF, NASAL DECON SPRAY, NASOPEN PE LIQ, NIGHT CGH LIQ, NINJACOF LIQ, NOHIST, NOSE DROPS, ORGAN-I, PED CGH-COLD LIQ, PHENYLEPHRINE-PYRILAMINE, POLY HIST, POLY-VENT, POLYTUSSIN, PROMETHAZINE, Q-TUSS, RESCON, RESPAIRE-30, ROBAFEN, RU-HIST D, RYMED, SILTUSS, SINUS RELIEF 1% NASAL SPRAY, SM NASAL SPRAY, SM TUSS DM, STAHIST AD, SUDOGEST SINUS & ALLERGY, TUSS, VANACOF, VANATAB |
1 MB |
PDF File
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Eff. Date: 09/21/2022
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KALYDECO, ORKAMBI, SYMDEKO, TRIKAFTA |
2 MB |
PDF File
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Eff. Date: 02/07/2023
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ACTEMRA, ARCALYST, CIBINQO, CIMZIA, COSENTYX, ENBREL, ENSPRYNG, HUMIRA, ILARIS, ILUMYA, KEVZARA, KINERET, OLUMIANT, ORENCIA, OTEZLA, RINVOQ, SILIQ, SIMPONI, SKYRIZI, STELARA, TALTZ, TREMFYA, XELJANZ |
2 MB |
PDF File
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Eff. Date: 02/07/2023
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DDAVP, DESMOPRESSIN ACETATE |
1014 KB |
PDF File
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Eff. Date: 03/12/2020
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ALA-HIST DM LIQ, AP-HIST DM LIQ, ALLFEN DM TAB, BROMFED DM CGH, BROMPHENIR-PSEUDO-DM SYR, BROTAPP DM LIQ, CHILD DELSYM, CHILD C&C DM ELIX, CHILD MUCINEX, DECONEX DMX TAB, DELSYM 30MG/5ML SUSP, DELSYM CGH+CHEST CNGST DM LQ, DEXTROMETHORPHAN ER 30MG/5ML, DIMAPHEN DM ELIX, ED-A-HIST DM LIQ, ED-A-HIST DM TAB, ENDACOF-DM LIQ, EXT ACTION CGH SYR, GUIAFEN-DM ER 1,200-60MG TAB, HISTEX-DM SYR, IOPHEN DM-NR LIQ, KIDKARE C&C LIQ, LOHIST-DM SYR, LORTUSS DM LIQ, M-END DMX LIQ, M-HIST DM, MAXIPHEN DM TAB, MUCINEX CGH MINI-MELT PACK, MUCINEX DM ER 600-30MG TAB, MUCINEX DM ER 1,200-60MG TAB, MUCINEX FAST-MAX CONG-CGH, MUCINEX FAST-MAX DM MAX LIQ, NOHIST-DM LIQ, PED C&C LIQ, POLY-HIST DM LIQ, POLY-VENT DM TAB, POLYTUSSUN DM, PROMETH-DM SYR, Q-TUSS DM SYR, RESCON-DM LIQ, ROBAFEN CF LIQ, ROBAFEN-DM, ROBAFEN CGH 15MG LIQGEL, ROBAFEN DM CGH-CHEST CONG SYR, RYNEX DM LIQ, SILTUSS DM CGH SYR, SILTUSS DM DAS LIQ, SM TUSS DM, TUSS DM, VANACOF DM LIQ, VANACOF DMX, VANATAB DM CAP, VIRDEC DM DRP |
220 KB |
PDF File
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Eff. Date: 10/22/2022
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DIACOMIT |
628 KB |
PDF File
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Eff. Date: 10/20/2022
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DICLOFENAC GEL 3%, DICLOFENAC SOL 1.5%, PENNSAID SOL 2% |
300 KB |
PDF File
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Eff. Date: 02/22/2021
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APOKYN, KYNMOBI |
606 KB |
PDF File
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Eff. Date: 10/29/2019
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BONJESTA ER, DICLEGIS DR |
254 KB |
PDF File
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Eff. Date: 3/27/2019
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ALOGLIPTIN, ALOGLIPTIN-METFORMIN, ALOGLIPTIN-PIOGLIT, GLYXAMBI, JANUMET, JANUMET XR, JANUVIA , JENTADUETO, JENTADUETO XR , KAZANO, KOMBIGLYZE XR , NESINA, ONGLYZA , OSENI , QTERN , STEGLUJAN, TRADJENTA |
314 KB |
PDF File
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Eff. Date: 10/07/2021
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EMFLAZA |
753 KB |
PDF File
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Eff. Date: 8/23/2022
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ALDURAZYME, CEPROTIN, ELAPRASE, FABRAZYME, GALAFOLD, NAGLAZYME, NITYR, ORFADIN, REVCOVI, STRENSIQ, VIMIZIM |
1 MB |
PDF File
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Eff. Date: 10/28/2022
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ARANESP, EPOGEN, PROCRIT, RETACRIT |
1 MB |
PDF File
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Eff. DAte: 06/09/2022
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EVRYSDI |
793 KB |
PDF File
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Eff. Date: 07/18/2022
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ACTIQ, FENTANYL, FENTORA |
3 MB |
PDF File
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Eff. Date: 10/18/2022
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AMITIZA, IBSRELA, LINZESS, ALOSETRON HCL, LOTRONEX, MOVANTIK, MOTEGRITY, RELISTOR, SYMPROIC, TRULANCE, VIBERZI |
2 MB |
PDF File
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Eff. Date: 06/02/2022
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ADLYXIN, BYDUREON, BYETTA, MOUNJARO, OZEMPIC, RYBELSUS, SOLIQUA, TRULICITY, VICTOZA, XULTOPHY |
787 KB |
PDF File
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Eff. Date: 06/08/2022
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GENOTROPIN, HUMATROPE, NORDITROPIN NORDIFLEX, NORDITROPIN FLEXPRO, NUTROPIN AQ, OMNITROPE, SAIZEN, SEROSTIM, SKYTROFA, ZORBTIVE |
2 MB |
PDF File
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Eff. Date: 11/16/2022
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BERINERT, CINRYZE, FIRAZYR, HAEGARDA, KALBITOR, RUCONEST, TAKHZYRO |
683 KB |
PDF File
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Eff. Date: 12/02/2022
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HP ACTHAR GEL |
405 KB |
PDF File
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Eff. Date: 10/07/2021
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JUXTAPID, PRALUENT, REPATHA |
1 MB |
PDF File
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Eff. Date: 10/19/2022
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ALDARA, IMIQUIMOD, ZYCLARA |
736 KB |
PDF File
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Eff. Date: 10/19/2022
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INCRELEX |
969 KB |
PDF File
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Eff. Date: 10/28/2022
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BETHKIS, CAYSTON, KITABIS PAK , TOBI, TOBRAMYCIN |
260 KB |
PDF File
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Eff. Date: 10/28/2022
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KETOROLAC |
382 KB |
PDF File
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Eff. Date: 10/28/2022
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KEVEYIS |
275 KB |
PDF File
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Eff. Date: 11/07/2019
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LIDOCAINE, LIDODERM, LIDOPURE PATCH, ZILACAINE PATCH, ZTLIDO |
306 KB |
PDF File
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Eff. Date: 07/05/2022
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LOVAZA, VASCEPA |
824 KB |
PDF File
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Eff. Date: 10/22/2021
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BENLYSTA, LUPKYNIS |
993 KB |
PDF File
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Eff. Date: 05/01/2022
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MAKENA |
254 KB |
PDF File
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Eff. Date: 10/28/2022
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ADBRY, DUPIXENT, FASENRA, NUCALA, XOLAIR |
2 MB |
PDF File
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Eff. 05/24/2022
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AMPYRA, AUBAGIO, DALFAMPRIDINE, MAVENCLAD, MAYZENT, PONVORY, ZEPOSIA |
1 MB |
PDF File
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Eff. Date: 10/28/2022
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GABAPENTIN, GRALISE, HORIZANT, NEURONTIN |
673 KB |
PDF File
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Eff. Date: 05/24/2022
|
NITAZOXANIDE |
678 KB |
PDF File
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Eff. Date: 3/29/2019
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NUPLAZID |
419 KB |
PDF File
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Eff. Date: 04/28/2022
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EYSUVIS, RESTASIS MULTIDOSE, RESTASIS EYE EMULSION, TYRVAYA, XIIDRA |
601 KB |
PDF File
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Eff. Date: 12/15/2022
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APAP-CAFF-DIHYDROCOD, APAP-COD, ACTIQ, APADAZ, ASCOMP/COD, BELBUCA, BELLADONNA-OPIUM, BUPRENORPHINE, BUTALB-APAP-CAFF-COD, BUTALB-CAFF-APAP-COD, BUTALBITAL COMP-COD, BUTORPHANOL, BUTRANS, CARISOPRODOL CPD-COD, COD-GUAIFEN, COD SULFATE, DEMEROL, DILAUDID, DOLOPHINE HCL, DSUVIA, DURAGESIC, DVORAH, EMBEDA ER, ENDOCET, FENTANYL, FENTORA, FIORINAL-COD, GUAIFEN-COD , GUAIATUSSIN AC, HYDROCODON-APAP, HYDROCODONE BT-IBU, HYDROCODONE-CHLORPHEN ER, HYDROCOD-HOMATROPINE, HYDROCODONE BT-IBU, HYDROCODONE-IBU , HYDROMET, HYDROMORPHONE, HYDROMORPHONE ER, HYSINGLA ER, KADIAN ER, LAZANDA NASAL SPRAY, LEVORPHANOL, LORCET, MEPERIDINE, METHADONE, METHADOSE, MORPHABOND ER, MORPHINE, MS CONTIN, NALBUPHINE, NALOCET, NINJACOF-XG, NORCO, NUCYNTA, NUCYNTA ER, OPIUM, OXYCODONE, OXYCODONE-APAP, OXYCODONE-ASA , OXYCODONE-IBU, OXYCONTIN, OXYMORPHONE HCL, OXYMORPHONE HCL ER, PENTAZOCINE-NALOXONE, PERCOCET, PROMET-COD, ROXICODONE, SUBSYS SPRAY, TRAMADO, TYLENOL COD, ULTRACET, ULTRAM, VICODIN, VIRTUSSIN, XTAMPZA ER |
1 MB |
PDF File
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Eff. Date: 10/28/2020
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ORIAHNN |
884 KB |
PDF File
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Eff. Date: 3/29/2019
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ORILISSA |
403 KB |
PDF File
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Eff. Date: 12/02/2022
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OXERVATE |
270 KB |
PDF File
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Eff. Date: 10/31/2022
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OXYCONTIN, OXYCODONE HCL ER, XTAMPZA ER |
2 MB |
PDF File
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Eff Date: 10/19/2022
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PALFORZIA |
606 KB |
PDF File
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Eff. Date: 10/31/2022
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ADCIRCA, REVATIO, SILDENAFIL, TADALAFIL |
685 KB |
PDF File
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Eff. Date:02/02/2022
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AURYXIA, CALCIUM ACETATE, CALPHRON, FOSRENOL, LANTHANUM CARB, PHOSLYRA SOL, RENAGEL, RENVELA, SEVELAMAR, VELPHORO |
818 KB |
PDF File
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Eff. Date: 10/19/2022
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PHENADOZ, PHENERGAN, PROMETHAZINE, PROMETHEGAN |
551 KB |
PDF File
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Eff. Date: 10/31/2022
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PROPYLTHIOURACIL |
399 KB |
PDF File
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Eff. Date: 02/07/2023
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ADEMPAS, LETAIRIS, OPSUMIT, ORENITRAM ER, TRACLEER, TYVASO, UPTRAVI, VENTAVIS |
220 KB |
PDF File
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01/24/2022
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PULMOZYME |
590 KB |
PDF File
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07/28/2021
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QELBREE |
753 KB |
PDF File
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Eff. Date: 10/31/2022
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RANEXA |
374 KB |
PDF File
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Eff. Date: 04/22/2022
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RECORLEV |
849 KB |
PDF File
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Eff. Date: 3/29/2019
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SAVELLA |
669 KB |
PDF File
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Eff. Date: 08.01.2022
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FARXIGA, INVOKANA, JARDIANCE, STEGLATRO |
800 KB |
PDF File
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Eff. Date: 10/19/2022
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OXBRYTA |
741 KB |
PDF File
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Eff. Date: 3/29/2019
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SYMLIN, SYMLINPEN |
250 KB |
PDF File
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Eff. 09/15/2022
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SYNAGIS 50 MG/0.5 ML VIAL, SYNAGIS 100 MG/1 ML VIAL |
842 KB |
PDF File
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Eff. Date: 11/11/2020
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ACTOPLUS MET, ACTOPLUS MET XR, PIOGLITAZONE-METFORMIN, ACTOS, DUETACT, PIOGLITAZONE HCL, PIOGLITAZONE-GLIMEPIRIDE, AVANDIA |
977 KB |
PDF File
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Eff. Date: 4/01/2022
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AMZEEQ FOAM, BENSAL HP OINTMENT, BENZACLIN GEL, BENZEFOAM, CLINDAMYCIN FOAM, CLINDAMY/BEN GEL, ERY/BENZOYL GEL, FINACEA FOAM, FINACEA GEL, METRONIDAZOLE LOTION |
655 KB |
PDF File
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Eff. Date: 10.22.2021
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CICLOPIROX SOL, JUBLIA SOL, KERYDIN SOL, TAVABOROLE SOL |
930 KB |
PDF File
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Eff. Date: 02/07/2023
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ELIDEL, EUCRISA, OPZELURA, PROTOPIC, TACROLIMUS |
756 KB |
PDF File
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Eff. Date: 04/01/2022
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ADAPALENE, ADAPALENE-BENZYL PEROX, AKIEF, ALTRENO LOTION, ARAZLO, ATRALIN, AVITA, CLINDA-TRETINOIN, DIFFERIN, EPIDUO, EPIDUO FORTE, FABIOR, TAZAROTENE, TAZORAC, TRETINOIN, TRETINOIN GEL MICRO, ZIANA GEL |
414 KB |
PDF File
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Eff. Date: 10/08/2021
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TEGSEDI, VYNDAMAX, VYNDAQEL |
738 KB |
PDF File
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Eff. Date: 4/26/2019
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BUPHENYL, CARBAGLU, RAVICTI, SODIUM PHENYLBUTYRATE |
169 KB |
PDF File
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Eff. Date: 10/15/2021
|
AUSTEDO, INGREZZA, XENAZINE |
1 MB |
PDF File
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Eff. Date: 04/22/2022
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VOXZOGO |
625 KB |
PDF File
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Eff. Date: 10/08/2021
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WAKIX |
675 KB |
PDF File
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Eff. Date: 3/29/2019
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XIFAXAN |
288 KB |
PDF File
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Eff. Date: 10/08/2021
|
XYREM, XYWAV |
670 KB |
PDF File
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Eff. Date: 10/08/2021
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ZELBORAF |
682 KB |
PDF File
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Eff. Date: 02/07/2023
|
ZYFLO |
483 KB |